COA 2016: Lateral vs crossed K-wire fixation for displaced supracondylar humeral fracture

Study Type: Randomized Trial
OE Level of Evidence: N/A
Journal Level of Evidence: N/A
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Synopsis
52 paediatric patients with a displaced supracondylar fracture of the humerus scheduled for K-wire fixation were randomized to either a lateral pin configuration or a crossed pin configuration. The purpose of this study to evaluate if lateral K-wire fixation offered non-inferior results regarding the loss of reduction when compared to crossed K-wire fixation. The quality of Please login to view the rest of this report. Please login to view the rest of this report.
Why was this study needed now?
Supracondylar fractures of the humerus are common among traumatic injuries in children, often resulting from a fall on an outstretched hand. While nonoperative management can often be used effectively in less severe cases, operative fixation is indicated in type III displaced fractures. Two methods of fixation include lateral K-wire fixation and crossed K-wire fixation. One of the main concerns following fixation with any method is the possible loss of reduction.
What was the principal research question?
In K-wire fixation of paediatric type III displace supracondylar fractures of the humerus, does a lateral K-wire configuration offer non-inferior efficacy based on the loss of reduction when compared to a crossed K-wire configuration, assessed at 3 weeks postoperatively?
Population: 52 patients, 3-7 years of age, a type III displaced supracondylar fracture of the humerus
Intervention: Lateral K-wire fixation group: Fracture fixation was achieved using two K-wires in a lateral configuration. Pins were removed at 3 weeks postoperatively (n=23; n=22 analyzed).
Comparison: Crossed K-wire fixation group: Fracture fixation was achieved using two K-wires in a crossed configuration. Pins were removed at 3 weeks postoperatively (n=29; n=23 analyzed).
Outcomes: The primary outcome was the rate of loss of reduction within 3 weeks of surgery, as assessed using the change in Baumann's angle from immediately postoperatively. Secondary outcomes included the Flynn's elbow score and incidence of iatrogenic ulnar nerve injury.
Methods: RCT
Time: Patients were assessed at 3 weeks postoperatively.
What were the important findings?
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What should I remember most?
How will this affect the care of my patients?
The authors responsible for this critical appraisal and ACE Report indicate no potential conflicts of interest relating to the content in the original publication.